Provider Demographics
NPI:1508313685
Name:SPIRITHORSE EQUINE ASSISTED THERAPIES LLC
Entity Type:Organization
Organization Name:SPIRITHORSE EQUINE ASSISTED THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-546-7497
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-0709
Mailing Address - Country:US
Mailing Address - Phone:406-546-7497
Mailing Address - Fax:
Practice Address - Street 1:33578 CANYON VIEW DR
Practice Address - Street 2:
Practice Address - City:SAINT IGNATIUS
Practice Address - State:MT
Practice Address - Zip Code:59865-9748
Practice Address - Country:US
Practice Address - Phone:406-239-4274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty